Month: August 2015

On Saturday the 22nd August over a thousand healthcare professionals will be protesting the government and attempting to educate the public about the value of and the dismantling of the NHS, because unless we do something drastic, it will soon be gone.

Myself and two rather inspiring and tirelessly hardworking colleagues are putting out a Crash Call from 12pm in Shepherds Bush Green- to try and resuscitate the NHS in the hearts and minds of the public, and call together campaign groups, staff, patients and lay people, through education and demonstration, to try to keep the NHS alive.

Too long has the government and certain media outlets’ agenda of NHS-bashing and staff demoralising gone on. Jeremy Hunts plan to ‘name and shame’ GPs, despite being physically and statistically impossible, was front page news. [1] Jeremy Hunt’s accusations that NHS consultants aren’t working seven days a week has been proven to be an outright lie, yet was reprinted, word for word, in several national newspapers. [2] The coalition Government was formed on a campaign promise of no front-line NHS reorganisations, and then once in power immediately embarked on the biggest, most damaging reorganisation in its 67 year history [4]. This time around David Cameron beat the stand and said ‘the NHS is safe in our hands’ [3] – while all the while it’s halfway out of his hands already.

If you don’t want a national publicly funded health service then that’s up to you. If you don’t want one of the cheapest [5] most efficient and equitable [6] systems in the developed world, while still managing to achieve some of the best outcomes [5] and put out cutting edge research [7], then that’s your decision.

But my suspicion is that it’s not a very informed decision. Whether you believe in the ideology of an NHS or not, the information and perception of the service put out by the government and the media is, unbeknownst to you, simply not true. All of the alternative comparable healthcare systems are more costly, more bureaucratic and less able or willing to care for the most vulnerable in our society.

Even if you do believe in a public health system, and might recognise the value of having, pound for pound, one of the best healthcare systems in the world, perhaps no one told you it’s being taken away- the service is being dismantled and belittled and kept in constant crisis.

No you say- a) the government has promised £8 billion extra funding over the next five years, and b) 5000 more GPs, c) seven-day opening times and d) greater safety in the service. Let’s look at that more closely.

A) The £8 billion is over five years, so that’s £1.6 billion extra cash per year. The predicted health funding required for the next five years is £30 billion short by 2020. [8] So every year the gap between NHS costs and NHS resource will grow, accumulating increasing underfunding, with a gap in the year 2020 alone predicted to be £30 billion, so £8 billion will not touch the sides.*

B) It takes 10 years to train a GP, 1 in 3 GPs are planning on retiring, closing or emigrating in the next five years [9] (approx 14,000 GPs), and 1/3 GP trainee spots are under-filled (2000 less new GPs total over the next 5 years). 2500 new GPs will qualify every year 2018-20 – so if GPs leaving at the rate now planned won’t be fully replaced, there will be 6500 LESS GPs than there are now.** So, the proposed 5000 extra GPs will actually need to be 11,500 GPs in order to be an expansion of the service, not a net loss. In short, if we have the SAME number of GPs we have today, we would be incredibly lucky, and more likely we will be thousands short. Meanwhile GP outcome has fallen for the past five years and the government is discussing cutting GP subsidy pay further.

C) Seven day working is already in place for all emergency work across the country [2] – while we are under-funding a system already at crisis point, perhaps it would be wise to try to stretch non-emergency services once there is the money to pay for it.

D) And the safety review board was about the only sensible and useful thing Jeremy Hunt has ever suggested.

What happened to democracy? Who voted for the collapsing of the NHS? It wasn’t on any campaign manifesto from any party, and yet here we are.

On Saturday over a thousand doctors, nurses, physios, OTs, medical students and other AHPs will be in Shepherd’s Bush Green in London from 12-4pm- teaching CPR to the public, talking to the public about the reality of the NHS and raising awareness that a great healthcare system is being dismantled with no democratic mandate to do so. There will be speakers and expert campaigners from many groups all fighting for the NHS. So whether you’re a lay person or a health professional, come along on Saturday- you might learn some vital skills that could save a life, and you will learn about the threats to the service and the staff saving lives everyday.

* Even with the most extreme ‘efficiency savings’/cuts of £22 billion a year this gap will still be £8 billion pound in 2020, and the NHS will be cumulatively underfunded by an estimated £33 billion pounds. So this extra £1.6 billion won’t even scratch the surface.
We already spend far less on healthcare than any country in the G7 bar Italy, currently 9.1% GDP. If we spent, currently, as much as Germany (11.1% of GDP) in our equivalent economy the NHS budget would be £160 billion, and we wouldn’t be cutting services, public health and vulnerable adult budgets away to make it work.

**And where 5000 new GPs will come from, if they aren’t already in training, by 2020, no one has detailed – in fact it would be impossible for them to come from a UK training system, so will have to be recruited from abroad or other medical specialties (which would require 3 years training regardless)

We are talking to ourselves. This is increasingly abundantly clear- the conversation about the privitazation of services and demoralisation of the workforce is not reaching beyond a closed-off Twittersphere and Facebook circles. Over 250,000 people read this blog in the last two weeks, and 211,000 people have signed the e-petition to date [1]. There are approximately 150,000 NHS doctors in this country[2] and that, plus family members and nurses, OT and physios, minus non-social media doctors and equivalents, is probably the sum activity thus far on #weneedtotalkaboutjeremy i.e. very few card-carrying members of the public.
The media coverage has been at best patchy, and at worst, disturbing. The story broke on the front page of the Independent this Saturday [3] and the Mirror has been covering it all along- but the lack of BBC coverage especially, deliberately not discussing the front page of the Independant on Saturdays breakfast show, highlights a disturbing relationship between the public and the media and politics. Many complaints thus far, including from this blog (see below), have so far been ignored.

And in the meantime many papers continue to spew headline errors that the most basic Googling can prove wrong in under a minute.
Take for example this article in the Express.* Stating over “Over half of doctors receive £75,000 pound bonuses and STILL won’t work weekends [para]”. It goes on to say 695 consultants receive bonuses of £50,000 to £75,000. There are around 38,000 NHS consultants in 2011-2012 [4] and, far from being ‘half’, this is 1.8%. Even being generous to the Express this is deliberately misleading. And, as is obviously clear, the FOI requests show all consultants are working weekends thus far (at time of writing now 1% of all consultants). [5] Here is a table of newspaper vs reality (all of which is Google-able in about 2-3 minutes).

What is most depressing is this news article is straight from the Government, word-for-word. Is this just lazy journalism or is it propaganda?
However vocal we are on social media the reality is that the ideas amongst the public form between the influence of the TV and the newspapers and by personal experience, of which there is very little on average of the NHS at an extensive level and working staff.
Which is why this weekend I went out to stage an ‘information protest’ in Hyde Park;

In my anecdotal, completely ill-designed, qualitative study of n=perhaps a dozen, the same themes came out over and over;

1) the NHS is inefficient and too expensive
2) doctors are overpaid and have too much leisure time
3) the NHS is not sustainable
4) the NHS is a middle to poor system compared to the rest of the world
5) The NHS is actually brilliant, but there’s nothing we can do to stop it being ‘sold off’.

When confronted with a few facts (a leaflet I gave them) about the system most of the public were genuinely surprised, and confused at the perception they had. But essentially, very easily persuaded to change their minds and sign the government e-petition once they were.

FACTS:

So the public need to be properly engaged – otherwise we will shout and scream on Twitter and Facebook, but we are only talking to ourselves. And proof-of-concept, seeing a doctor on the street is a novel and enticing means to start the conversation with those who we wouldn’t normally reach, to challenge the negative perceptions of the NHS, and rally support to defend it.

With that in mind let’s go out on the street en masse and try to save the NHS, a health organisation beset by media and political illness, by engaging the public in a novel and meaningful way. So we are putting out a 2222 call.

“Crash call for the NHS: The Doctors Will See You Now” is a mass protest on the 22nd August in London, venue and permits pending: a CPR marathon (on mannequins) to symbolise how we as health professionals are fighting to keep the NHS alive, despite the best efforts of a Health Secretary clearly aligned against it. We will be educating the public on basic resuscitation at the same time and hopefully replicating the opportunity for lay people to talk to doctors, nurses and other AHPs about the NHS, with just the facts, as above.

But we will need help. Lots of help. So if you want to DO something about all this mess, and try to really raise the profile of this campaign, then it’s time to go to the mattresses. If you are a doctor or nurse or AHP: Sign up here to volunteer to speak with the public and leaflet. If you are a member of the public, come along, and not only learn some skills which may save a life one day but show your support for the NHS, pound-for-pound the best healthcare system in the world.

Facebook: https://www.facebook.com/events/924528464275056/

Twitter: @CrashCallForNHS

Yes #weneedtotalkaboutJeremy, but if we only talk to each other, we won’t get anywhere at all.